Organization
ILLINOIS SKIN CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID OTHMAN MD (PRESIDENT AND CEO)
(312) 600-5826
Entity
Organization
Contact information
Practice address
2202 N HALSTED ST STE 1, CHICAGO, IL 60614-3625
(312) 600-5826
(872) 260-5008
Mailing address
2202 N HALSTED ST STE 1, CHICAGO, IL 60614-3625
(312) 600-5826
(872) 260-5008
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
332900000X
Non-Pharmacy Dispensing Site
—
—
Other
Enumeration date
04/10/2020
Last updated
02/27/2025
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